Energy conversion and management, Vol. An integrated spectral dependent electrical—thermal model has been developed. The effect of atmospheric parameters on system's performance is evaluated. Case studies show the impact of heat transfer coefficient on annual energy yield.
Objectives This retrospective analysis, using routinely available data from vital registration, aimed to assess the impact of IMCI implementation between and on child mortality. It also presents a systematic and comprehensive approach to scaling-up IMCI interventions and information on quality of child health services, using programme data from supervision and surveys.
Methods We compared annual levels of under-five mortality in districts before and after they had started implementing IMCI. Mortality data were obtained from the National Bureau for Statistics for districts for the years —, 41 districts of which were excluded. For assessment of programme activities, we used information from the central IMCI data base, annual progress reports, follow-up after training visits and four studies on quality of child care in public health facilities.
Results Across districts retained in the analysis, the estimated average annual rate of decline in under-five mortality was 3. In districts which started implementing IMCI between andthe average annual rate of decline of under-five mortality was 2.
IMCI implementation also led to marked improvements in the quality of child health services.
Interpretation IMCI implementation was associated with a doubling in the annual rate of under-five mortality reduction 3. This mortality impact is plausible, since substantial improvements occurred in quality of care provided to sick children in health facilities implementing IMCI.
Primary Care, Public Health Article summary Article focus Assesses the impact of the strategy on Integrated Management of Childhood Illness IMCI on child mortality, through a retrospective analysis, using routinely available data from vital registration and surveys. Describes the effect of IMCI on quality of child health services, using programme data from supervision and surveys.
Presents a systematic and comprehensive approach to scaling-up IMCI interventions under routine programme conditions. Key messages IMCI implementation was associated with a doubling in the annual rate of under-five mortality reduction 3.
Substantial improvements occurred in the quality of care provided to sick children in health facilities implementing IMCI.
Strengths and limitations of this study The evaluation covered IMCI implementation at national scale in a country with a large population. Therefore, it is of a different magnitude to previous IMCI evaluations. The evaluation was based on data that were routinely collected through the national health information system that were corroborated with findings from independent surveys.
This is a unique strength currently called for in the recommendations of the UN Commission on Information and Accountability, which aims to accelerate progress towards the MDGs. The paper describes a systematic model of scaling-up the IMCI strategy that can be replicated and is relevant for other settings.
The analysis was based on an observational design and therefore is open to selection and measurement biases and confounding. Health service utilisation in relation to IMCI implementation and changes in population-based coverage with other interventions could not be assessed.
The mortality impact is plausible, since substantial improvements occurred in all four components of the causal pathway, from health facility supports to appropriate management of child illness, caregiver knowledge about home care and caregiver satisfaction with the services received.An integrated molecular dynamics, principal component analysis and residue interaction network approach reveals the impact of MV mutation on HIV reverse transcriptase resistance to rutadeltambor.com#!divAbstract.
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